• Arn Migowski, Gustavo Tavares Lameiro da Costa, and ReyHelena Cramer VeigaHCVEducation and Research Coordination, National Institute of Cardiology (INC), MoH, Rio de Janeiro, RJ, Brazil..
• Epidemiology Unit and Professional Master's Program in Health Technology Assessment, Education and Research Coordination, National Institute of Cardiology (INC), Ministry of Health (MoH), Rio de Janeiro, Brazil; Division of Clinical Research and Technological Development, Research and Innovation Coord., National Cancer Institute (INCA), MoH, Rio de Janeiro, Brazil. Electronic address: arnmigowski@yahoo.com.br.
• Prev Med. 2024 Sep 18; 189: 108141108141.

ObjectivesTo estimate the coverage of newborn pulse oximetry screening (POS) in Brazil, as well as identifies associated factors and the proportion of positive screening results.MethodsCoverage was estimated based on the most recent National Health Survey (2019). Adjusted marginal prevalence ratios were estimated via poisson regression model with robust variance.ResultsThe POS coverage was 66.3 % (95 %CI: 65.5-67.1; N = 3,140,023) and was higher in children born in privately funded hospitals (PFHs) than in the Unified Health System (SUS): 78.1 % (76.7-79.5) versus 61.1 % (60.2-62.1). In the North region, the POS coverage in PFHs (64.9 %, 59.7-70.1) was lower than that in the South (82.5 %, 79.4-85.6) and the Southeast (81.5 %, 79.3-83.6); it was even lower in SUS in the North (44.0 %; 42.4-45.6). After a federal ordinance providing financial resources to postscreening diagnostic, the screening coverage in SUS increased from 57.6 % (56.2-59.1) to 64.6 % (63.3-65.9). The proportion of positive screening tests was 9.2 % (8.9-9.5) in SUS and 7.8 % (7.3-8.3) in PFHs, of which 40.8 % (40.5-41.1) underwent complementary exams in SUS and 57.2 % (56.7-57.7) in PFHs. In the multivariate model, the main independent predictors of POS were the coverage of other newborn screening tests.ConclusionsInequalities were found between major regions and healthcare systems. Government financial incentives have reduced this inequality, although the percentage of postscreening complementary exams remains insufficient and unequal. The main independent predictors of screening prevalence were those related to the organization of health services.Copyright © 2024. Published by Elsevier Inc.

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